Study of electrolyte patterns in elderly admitted with infection

Abstract

Background: Sparse published data are available regarding electrolyte abnormalities in elderly patients admitted to hospital with infection.Methods: We retrospectively studied the case records of 115 elderly patients (aged >60 years) admitted with 131 episodes of admissions due to various infections to the geriatric medicine wards and intensive care unit in our tertiary care teaching hospital during January 2018– September 2019.Results: Their mean age (years) was 79.1 ± 8.2 years; there were 58 (50.4%) females. Seven patients were admitted twice; one patient was admitted thrice with infection. The common sites of infection were lower respiratory tract (n = 58, 44.3%); urinary tract (n = 56, 42.7%); cellulitis, wound and soft-tissue infections (n = 22, 16.8%); and sepsis and related syndromes (n = 11, 8.4%). The common comorbid conditions included hypertension (67.8%), diabetes mellitus (45.2%), coronary artery disease (26.1%) and chronic kidney disease (12.2%). Hyponatraemia was the most common electrolyte abnormality seen in 53/131 (40.5%) episodes followed by hypocalcaemia (35/112, 31.2%), hypokalaemia (22/131, 16.8%), hypernatraemia (n = 1), hyperkalaemia (n = 9), hypercalcaemia (n = 2), hypomagnesaemia (n = 15), hypophosphataemia (n = 11) and hyperphosphataemia (n = 3). All patients with dyselectrolytaemia were receiving multiple (median [interquartile range (IQR)] 6 [3.75–8]) drugs. The median (IQR) duration of hospital stay was 6 (4–10) days. Eight of the 115 (7%) patients died; four of these eight patients had been admitted more than once with infection. There was no statistically significant difference in the proportion of patients with hyponatraemia (65/108 vs. 3/8; P = NS) and hypokalaemia (8/108 vs. 1/8; P = NS) among survivors and non-survivors.Conclusions: Dyselectrolytaemia is a common correctable metabolic abnormality seen in elderly patients hospitalised with infections. Careful monitoring and instituting correction can be life-saving.